[Hyperreactive malarial splenomegaly: three clinical cases and literature review].
Hyperreactive malarial splenomegaly (HMS) is the chronic stage of a long-term stimulation of the immune system secondary to plasmodial infections, more frequently in genetically predisposed patients. HMS is a leading cause of large tropical splenomegaly in endemic zones but has been described in immigrants from Africa and in some European expatriates living in endemic countries. Diagnostic criteria include: long-term stay in a endemic zone, often large splenomegaly, high IgM titer, high antiplasmodial antibody titer, regression by at least 40% of splenomegaly six months after curative antimalarial treatment. In tropical settings, B-cell lymphoma and splenic lymphoma are the main differential diagnoses, which may be identified by a clonality analysis. Recent studies suggest that HMS can be treated by a short-term antimalarial therapy as long as the patient resides out of a malarial endemic country.
Camara
B
B
Service de maladies infectieuses et tropicales, hôpital Purpan, 1, place Baylac, 31059 Toulouse, cedex 9, France.
Kantambadouno
J-B
JB
Martin-Blondel
G
G
Berry
A
A
Alvarez
M
M
Benoit-Vical
F
F
Delmont
J
J
Bouchaud
O
O
Marchou
B
B
D000293:Adolescent; D000328:Adult; D000349:Africa; D000368:Aged; D000818:Animals; D016535:Bronchial Hyperreactivity / Q000276:immunology; D003937:Diagnosis, Differential; D054242:Emigrants and Immigrants; D005060:Europe; D005260:Female; D006801:Humans; D008288:Malaria / Q000276:immunology*; D008297:Male; D010963:Plasmodium falciparum / Q000302:isolation & purification; D013163:Splenomegaly / Q000209:etiology* / Q000276:immunology* / Q000469:parasitology